PB2658: IMMUNE THROMBOCYTOPENIC PURPURA IN ALBANIA
Authors: Sara Grazhdani, Alma Cili, Aldo Shpuza, Adela Perolla, Elsuarta Calliku, Polikron Pulluqi, Tatjana Caja, Albana Fico, Arben Ivanaj
Journal: HemaSphere (2023)

Topic: 33. Bleeding disorders (congenital and acquired) Background: Immune Thrombocytopenic Purpura (ITP) is an autoimmune disease characterized by the destruction of platelets by immune mediators, their deficient production in the red bone marrow leading to the appearance of thrombocytopenia and increased risk of hemorrhage. Treatment is indicated in patients with low platelet counts (<30 x 10 9/L), who present clinically with hemorrhagic events or are at increased risk for hemorrhage. Corticosteroid therapy remains the first choice in the treatment of patients with Primary ITP, and Rituximab remains the first choice in the second line, in the treatment of patients with ITP, refractory to the use of cortisones in Albania. Aims: Evaluation of treatment efficiency and analysis of epidemiological, clinical, diagnostic indicators of patients diagnosed with ITP in the Hematology Service in the period January 2021-December 2022. Methods: This was a case-series study with retrospective directional approach. The sample of this study was 69 patients. We obtained the data of the patients from the medical records at University Hospital Center Mother Teresa. The including criterias were: Patients of both sexes (male, female), aged >18 years, patients diagnosed with Primary ITP, and patients diagnosed with Refractory ITP. The exclusion criterias were: Pregnant, lactating patients, and patients who have other concomitant malignant diseases. Sampling frame was almost consecutive. Kaplan Meier curve was used to calculate the probability that patients have, to relapse over time, after applying different therapies. The dependent variable (event) we studied was relapse. Results: The average age of patients was 46.7 years, while 67% of them were females and 33% males. The clinical features shown in the studied patients turned out to be petechiae 58% (n=40) and ecchymosis 42% (n=29). The average length of hospitalization was 7.6 days. Patients treated with Prednisolone had an average remission time of 12.7 months, compared to patients who were treated with Rituximab, where the average time was 20.9 months. Patients under treatment with Prednisolone, the probability of relapse is calculated at 2% in month 3, patients treated with Rituximab, the probability of relapse is calculated at 2% at month 7-8. The distribution of hospital stay days was 9.28 days in patients treated with Prednisolone and 5.14 days in patients treated with Rituximab (p=0.01). The mean survival time of corticotherapy was 12.7 months, while the median was 14.0. The mean survival time for Rituximab was 20.9 months Summary/Conclusion: Young women were more affected. Second-line Rituximab treatment was more effective compared to Prednisolone treatment in patients with refractory ITP who failed first-line corticosteroid therapy in Albania. The length of stay in patients treated with Rituximab was significantly lower than the length of stay in patients treated with Prednisolone. With increasing age, patients tend to show lower levels of thrombocytopenia. The level of thrombocytopenia was lower in women compared to men. Keywords: Immune thrombocytopenia (ITP), ITP